Malnutrition.ppt

Protein-energy malnutrition The Second Affiliated Hospital of Shantou University Medical College Ma Lian Protein-energy malnutrition Definition?? Protein-energy malnutrition is the nutrition deficiency because of energy and protein . It is common below 3 years old. The clinical manifestations: initiated with failure to gain weight, followed by loss of weight, decrease and disappearance of subcutaneous fat and disorders of multiple organs and tissues. Nutrition 在婴儿发育的关键时期，某一营养素是否足量或缺乏，可能导致长期、甚至永久性的影响. 婴儿期的营养影响到今后的心血管疾病的危险因素（血压、脂肪代谢、胰岛素抵抗、体脂）. 早期营养会对以下方面有影响：终身的血压、胆固醇水平、代谢、胰岛素抵抗、体脂、动脉硬化、骨骼健康、行为学习能力、甚至寿命的长短. Children condition 　　　 Etiology? （1）Inadequate calorie intake. （2）Insufficient digestion and absorption(disease). （3）Requirements increasing. （4）Consumption enlarging Etiology 。 Pathophysiology （1）Metabolism abnormality: protein/sugar/fat/water/salt/ （2）Disorder of multiple organs and tissues. immune: nerve: others: Clinical manifestation Failure to gain weight followed by loss of weight. The order of decrease and disappearance of subcutaneous fat Abdomen → trunk → buttock → extremities → face. The disorder of multiple organs. Clinical types and degrees A. Marasmus; B. Edema C. Intermedia Marasmus could be divided into different degrees according to the loss of weight and others. Clinical types and degrees A. Below 3years old, it is divided into three degrees： Weight: mild mid severe. 15% 25% 40% fat: 0.8 0.5(0.4) 0(cm) B. Above 3 years old, it is divided into two degrees：mild and severe Complications? （1） Anemia （2） Vitamins deficiency （3） Infections （4） Spontaneous hypoglycemia （5） Disorder of water and electrolyte Diagnosis It is common below 3 years old. History：feeding history. Clinical manifestation. Laboratory examination：IGF-1, PAB etc Treatments （1） Exclude causes （2） Adjust diet （3） Facilitate digestion